Introduction
The COVID-19 pandemic has prompted the implementation of telemedicine programmes to facilitate healthcare. In November 2020 we initiated an e-consultation programme between primary care and the neurology department, with asynchronous response, through a platform integrated into the corporate computer system of the Andalusian Public Health System. We present the results of the first year of operation.
Methods
We present a descriptive study of the e-consultations received in 2021 from a health area of approximately 300,000 inhabitants aged ≥14 years. The reasons for consultation were pre-established: “primary headache” (PH), “new-onset cognitive impairment” (CI), “complications of dementia” (DEM), and “epilepsy” (EPI). We defined inclusion criteria and the clinical information/tests that had to be provided. General practitioners could choose between e-consultation or face-to-face referral.
Results
A total of 1,806 e-consultations were received (approximately 6/1,000 population/year). By reasons for consultation: CI 34.3%, PH 32%, DEM 14.4%, EPI 11.7%, unspecified 7.6%. Responses were sent after an average of 2.25 days and were classified as: “refer for in-person consultation” (47.12%), “resolved” (39.98%), “criteria not met” (12.57%), or “follow-up by e-consultation” (0.33%). As expected, a high proportion of face-to-face referrals were required for CI (73.46%); the main value of the system for these patients was to prioritise appointments and select the most appropriate form of care. For the rest of the reasons for consultation, the proportion of “resolved” e-consultations reached 52.61%.
Conclusions
Asynchronous e-consultation between primary care and the neurology department is a useful tool in the indicated conditions, offering a rapid, “one-stop” response to a significant proportion of clinical or therapeutic uncertainties, as well as optimising face-to-face appointments.
